Seminars in cardiothoracic and vascular anesthesia
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Semin Cardiothorac Vasc Anesth · Dec 2005
ReviewUsing cardiovascular and pulmonary simulation to teach undergraduate medical students: cases from two schools.
Simulation is becoming more widespread in undergraduate medical education, expanding well beyond its original application to anesthesiology. This heightened interest in simulation is being driven by advances in learning theory as well as technology developments. However, introducing simulation into a medical education curriculum presents significant challenges. ⋯ Both are state schools with similar enrollments; however, their approaches to developing and maintaining a simulation program differ. Regardless of these differences, both institutions have developed a variety of applications within the curriculum. The cases and applications that they have developed should be applicable to many medical schools.
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Semin Cardiothorac Vasc Anesth · Dec 2005
ReviewSimulation in cardiology and cardiothoracic and vascular surgery.
Cardiologists and cardiac surgeons are rapidly embracing the use of realistic patient simulators and virtual reality devices to allow mastery of complex techniques, planning of complicated procedures, crisis management of infrequently seen diseases and complications, and development of medical team work. Simulation can certainly be used for these purposes in surgical education but provides only the ;;tip of the iceberg'' of the knowledge needed by the competent cardiothoracic, vascular, or general surgeon. Is simulation really the way to learn how to perform actual surgical procedures? This review will describe available surgical simulation technology, and define some of the problems to be solved for validation and general acceptance.
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Semin Cardiothorac Vasc Anesth · Dec 2005
ReviewSimulation-based education for cardiac, thoracic, and vascular anesthesiology.
Simulation has been used for medical teaching and testing for at least four decades in some form, such as that used for cardiopulmonary resuscitation training; however, new technology applied to medical and procedural training has recently led to a marked increase in the use of simulation-based instruction. Educational theory has further supported simulation for medical education and procedural training. ⋯ This review describes some of the current simulation-based education techniques related to cardiovascular and thoracic anesthesiology. Additional discussion covers some of the applicable educational theory and the expected future uses of simulation modalities in healthcare education, testing, and practice.
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Ventricular assist devices (VADs) have revolutionized long-term care for patients with congestive heart failure. These patients represent about 1% of the adults in the United States, considering that heart failure is a contributing factor in more than 250,000 deaths annually. ⋯ At least four assist devices are clinically available, and two other devices are being investigated. Because cardiopulmonary by-pass is required for implantation of these devices, anesthetizing these critically compromised patients requires extensive monitoring, skillful anesthetic management, and expert postoperative care.
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One-lung ventilation is used during a variety of cardiac, thoracic, and major vascular procedures. Endobronchial tubes, bronchial blockers, and occasionally, single-lumen tubes are used to isolate the lungs. ⋯ Finally, intraoperative hypoxia and hypercarbia in patients with intrinsic lung disease frequently complicate one-lung anesthesia. The concepts and controversies in lung isolation techniques are discussed.